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What is Ecstasy?
Ecstasy is the most common street name for 3,4-Methylenedioxymethamphetamine (MDMA). The substance, an illegal drug, is a synthetic (man-made), psychoactive agent having chemical similarities to both methamphetamine and mescaline, making it a popular club drug.
Methamphetamine is a stimulant, while mescaline is a hallucinogen. Other street names for Ecstasy include Adam, Molly (short for “molecular,” referring to its laboratory origins), XTC, X, beans, hug drug, and the love drug.
History of MDMA and Ecstasy
The pharmaceutical company Merck received a patent for MDMA in 1914, but it was relatively obscure for decades until the 1950s and 60s, when the United States military and intelligence agencies experimented with it, first as a stimulant and then as a potential tool for brainwashing and mind control. It was abandoned, but in the 1970s therapists began using it on an experimental basis to facilitate therapeutic interactions, because it appeared to foster communication and increase empathy, getting patients and clients to open up during counseling and talk about their feelings. A seminary student, Michael Clegg, used it and became a passionate advocate, first giving it to friends and then selling it, even after becoming a priest. The drug became popular, particularly in the club and rave scene in the early to mid-1980s; Clegg named the drug Ecstasy, and in 1984, set up a mail order operation.
This brought MDMA to the attention of the federal Drug Enforcement Agency, which reacted swiftly and on a temporary basis in 1985 classified it as a Schedule I drug under the Controlled Substances Act, a category reserved for drugs deemed to have high abuse potential and no medical value. Psychiatrists, therapists, physicians and researchers felt that was an over-reaction, but despite several years of hearings and legal challenges, the classification became permanent in 1988.
The Science of MDMA
Ecstasy is usually sold in tablet or capsule form, although it is increasingly available as a crystalline powder. When taken in pill form, the effects are felt within 30-45 minutes, and last 3-6 hours. As an illegal, man-made drug, the strength is variable, but pills usually contain 60-120 milligrams of the active ingredient. Ecstasy has a stimulating and, in higher doses, hallucinogenic impact on the mind of the user. The drug also has an energizing effect, distorts the perception of time, and heightens sensory perception including tactile experiences.
Ecstasy is one of many illicit designer drugs considered psychostimulants, which activate monoamine neurotransmitter systems in the brain. MDMA stimulates the release of dopamine, serotonin and norepinephrine, which is created from dopamine, but it has the most significant impact on serotonin. Serotonin affects mood, thought processes, regulation of body temperature and sleep, among other things. Dopamine affects feelings of pleasure, mood, attention and sleep. Norepinephrine, also called noradrenaline, affects heart rate, and energy. Ecstasy stimulates the release of these neurotransmitters, and interferes with their reabsorption, causing them to accumulate in the brain, causing the high. Experiments with animals have shown that MDMA might also activate neurons in the hypothalamus associated with secretion of the hormone oxytocin, popularly called the “love hormone.”
Ecstasy interferes with the natural production of serotonin, causing reduced levels after it wears off. This can cause difficulty concentrating, as well as disruption of sleep.
Extent of Ecstasy use in U.S. population
Estimates put the number of people in the U.S. who have used MDMA or Ecstasy at least once at 10-12 million. The average age for first use of Ecstasy in 2012 was 20.3 years old. Estimated prevalence of Ecstasy use is just under 1 percent of the U.S. population. The number of people who reported using Ecstasy in 2012 for the first time was 869,000, down slightly from the previous two years. However, the number rose sharply from 615,000 in 2005 to 1.1 million in 2009.
According to a December 2013 federal Substance Abuse and Mental Health Services Administration (SAMHSA) report, the number of U.S. teens using Ecstasy has nearly doubled over the past few years. MDMA-related hospital emergency department visits by people under the age of 21 increased 128 percent from 2005 to 2011. SAMHSA reported that the visits increased from about 4,500 to more than 10,000 during that period. The Monitoring the Future survey (MTF), conducted by the University of Michigan's Institute for Social Research, reports that in 2010, 4.6 percent of 12th-graders, 4.7 percent of 10th-graders, and 2.4 percent of 8th-graders reported using Ecstasy in the previous year.
Ecstasy is sometimes described as either an empathogen or an entactogen, two synonymous terms coined in the 1980s to describe the distinctive state of mind characteristic among users of MDMA and related drugs.
Ecstasy is known for producing feelings of euphoria, empathy and emotional closeness to others.. It also increases energy and feelings of relaxation, reduces inhibitions, and enhances awareness of sensations including touch and sound.
Users are mainly attracted to Ecstasy for its physical and psychological effects. When taken alone, Ecstasy is potentially hallucinogenic in higher doses, and some people use it in combination with other drugs, including marijuana, LSD, psilocybin mushrooms and ketamine.
MDMA produces feelings of energy, euphoria and empathy. It makes people feel more sociable, and decreases negative emotions such as anxiety, fear, paranoia and stress. Short-term physical effects include increased heart rate and body temperature, dilated pupils, grinding teeth and clenching jaw muscles, and jumpy eye movements.
Risks and Adverse Physical Effects
In addition to Ecstasy’s mood altering effects, other potential effects include:
- Rapid heart rate and breathing
- Increased blood pressure
- Nausea and vomiting
- Involuntary jaw clenching and teeth grinding
- Dry mouth
- Dilated pupils
- Sweating and dehydration
Ecstasy is an illegal drug, and as such, there is a hidden risk that a person who takes it in any form may also consume other unknown, and potentially dangerous, substances. Another major risk of MDMA use is that it causes dehydration and also affects the body’s ability to regulate its temperature. MDMA decreases heat loss by constricting blood vessels near the skin, while causing the brain and muscles to produce more heat. As a result, it can cause core body temperature to rise to the point where it causes organ failure and death. This risk is even greater in a hot, crowded environment like a club where people who have consumed the stimulant are dancing energetically.
People who are taking prescription Monoamine Oxidase (MAO) inhibitors (usually prescribed to treat depression accompanied by anxiety), should not use Ecstasy because of its stimulant properties. Amphetamines and MAO inhibitors in combination are known to increase blood pressure to the point where it can cause hypertensive reaction, causing the heart to beat so fast that it becomes life-threatening.
People dancing in clubs after taking Ecstasy have demonstrated cortisol levels as much as 800 percent higher than normal. Cortisol converts proteins to energy, but high levels for prolonged periods of time can interfere with digestion, metabolism and mental function, as well as weakening the immune system.
Cognitive and Psychological Effects of Ecstasy
High doses of MDMA given to animals in experiments have been shown to cause damage to neurons, affecting mood, thought processes and judgment, but this damage appears to heal over time with abstinence. Similar neurotoxicity has not been clearly demonstrated in humans. Ecstasy can cause significant physical, psychological, and neurological damage to long-term users. Some research suggests that adverse effects of the drug on the brain occasionally persist even after prolonged abstinence. MDMA appears to have the potential to damage brain serotonin neurons in humans, thereby interfering with pain perception and sleep architecture.
Studies investigating Ecstasy and cognitive deficits including memory performance have been inconclusive. A study funded by the National Institute for Drug Abuse (NIDA), published in 2011, found little evidence of decreased cognitive performance among Ecstasy users. However, another study, published in the journal Addiction in 2012, found deterioration in the performance of a specific memory task called paired associates learning (involving memorization of pairs of words or objects so that when one is seen it triggers recollection of the other one) among Ecstasy users.
People who use Ecstasy along with other drugs (polydrug users) are also reported to have altered brain activation, as well as impaired cognitive function. It may cause decline in verbal memory. Users commonly demonstrate deficits in retrospective memory, prospective memory (forgetting the intention to do something), higher cognition, problem solving and social intelligence. However, basic cognitive skills may remain intact.
There is ample evidence to suggest that chronic, heavy, long-term use of ecstasy may increase susceptibility to sleep disorders, depressed mood, increased anxiety levels, impulsiveness and hostility, and selective impairment of episodic memory, working memory and attention. The psychological problems associated with Ecstasy use may be due to ecstasy-induced neurotoxicity and behavioral deficits, depletion of serotonin in heavy ecstasy users, and by dose-response relationships between the extent of exposure to ecstasy and the severity of cognitive impairments.
Is Ecstasy Addictive?
Experts have not come to an agreement as to whether ecstasy is addictive or not. Some studies have shown that it might cause dependency in users, while others show that although it has a high potential for abuse, it does not lead to dependency. One survey of young adult and adolescent MDMA users found that 43 percent of reported users met the criteria for dependence, and 34 percent met the criteria for ecstasy drug abuse. Ecstasy causes withdrawal symptoms in 60 percent of users, making finding an appropriate ecstasy drug treatment program important.
Treatment for Ecstasy Addiction and Abuse
Ecstasy can cause many physical, psychological, and social problems. When a person begins to abuse, or becomes addicted to, ecstasy, it is important to go through a professional program at one of the ecstasy treatment centers, such as DTRC, to overcome the problem. Ecstasy rehab provides a person the opportunity to address all the causes contributing to the abuse or addiction, including biological, social, and psychological. The best form of treatment will include detox and drug education alongside psychological treatment to address the underlying and co-occurring conditions fueling the drug use.
Ecstasy Addiction Treatment at DTRC
The ecstasy rehab centers at Drug Treatment and Rehab Centers (DTRC) offer state-of-the-art, evidence-based treatment for substance abuse and addiction. Our programs combine experiential and expressive treatment modalities that address all underlying and co-occurring conditions. Our biopsychosocial methods provide holistic treatment that reduces the risk of relapse. You can learn more about our programs by calling (646) 666-7461.